Posts Tagged "menopause"

Working through the menopausal transition..the first step is the deepest

Posted by Liz on Feb 21, 2011 in Work/occupation | 1 comment

Back in July of last year, I wrote a post entitled ‘Working through the transition? Or is the transition working you?’ In it, I discussed some research being conducted in the UK that is looking at the effect of menopause and its accompanying symptoms on the work environment and preesenteism, i.e. impact on productivity while at work. Not surprisingly, an overwhelming majority of women surveyed reported that their symptoms, namely fatigue and insomnia, were impacting workplace functioning and relationships with managers and co-workers. Less clear, however, were the roles of other factors, like perceptions and stress.

This raises one of the most common and yet inconsistently addressed issues during menopause: quality of life.

Quality of life is a subjective construct and one that is significantly influenced by a multitude of factors that intersect at any given time, factors such as how well we function, what we think about our lives, how we deal with stress, the type of social and economic support we have and overall wellbeing. And when you throw a bunch of symptoms like hot flashes, depression, anxiety, insomnia, backache, joint pain or forgetfulness on top of any of these, well, all hell can and does break loose!

When researchers looked at 184 women in both early and late transition to menopause who were part of the larger, Seattle Women’s Health study, they learned just how intricate the interrelationship between all these factors truly is. Indeed, among women in their mid to late 40s who were juggling work, families and relationships, the degree to which symptoms interfered with work most relied on how they perceived their health, their life stress and how depressed they were or were not. The findings:

• Symptoms like hot flashes, mood issues, sleep issues, pain, or concentration had a significant impact on work productivity.
• However, when researchers started to tease out and analyze the symptoms over time, they found that  how symptoms influenced how women felt about their health was most important. If women felt that their health was excellent or very good, symptoms tended affect their work productivity to a lesser extent than if they perceived their health to be poor or only moderate.
• Perceived stress levels reportedly influenced both work productivity and social/intimate relationships.
• Depression and difficulty concentrating were the final straws in the work/relationship back, affecting performance and the ability or interest in socializing or engaging in intimate or family relationships.

The one thing that these reports and the UK reports had in common were nighttime awakening.

So, let’s take a look at this. How we feel about our wellbeing affects work productivity, as does stress. If we are depressed or have difficulty concentrating, the ability to focus and be productive, either at work or in our worlds in general, starts to fall apart. Frequent awakening during the nighttime hours as a result of both aging and hormones can cause fatigue, depressed mood and concentration issues. In turn, this can influence how well we function  at work and at home and the quality of our relationship, to ourselves, our children and our partners.

The conclusion is that we need to step back, take stock and think about how we feel and how that is affecting our wellbeing and our lives.

The solution isn’t simple. Part of it lies in learning how to best address symptoms like sleep disturbances, depression or focus. The other lies in openly communicating to our work colleagues, our managers, our partners and our friends how productivity and our relationships may be suffering and actively involve them in finding solutions to improve wellbeing.

It’s hard work, no doubt. But the more insight we have, the better we are able to deal. And while it starts within, without it, the menopausal tendrils can extend far and widely into our lives.

The first step? Step back deep within yourself, and take stock. It may ultimately be the insight that you need to turn those symptoms on their side where they belong.

Are you getting the sleep you need?

Posted by Liz on Feb 14, 2011 in sleep disturbance | 4 comments

Sleep.

Sometimes I don’t even know what that means any longer. I long for the day (night) that I sleep a solid eight hours without awakening. However, that may the thing that my dreams are made of.

As I’ve written previously on Flashfree, sleep becomes more of an issue as we grow older.  Factors like less efficient sleep and a greater difficulty staying asleep can lead to depression and affect overall wellbeing. More frustrating than  the lack of sleep however, is the fact that experts can’t quite agree on the key factor underlying sleep disruptions: is it aging? Hormone fluctuations? Apnea? Moreover, do you treat the cause or the factor?

Besides my own personal interest in the topic, I do believe that the more that individuals understand the factors affecting their sleep quality, the greater their ability to proactively do something about it. That’s why I am always intrigued when I run across new research, like this study on isoflavones and sleep in the February edition of Menopause.

In it, 38 menopausal women who qualified as insomniacs (i.e. having difficulty falling or staying asleep or whose sleep is disrupted or insufficient enough to affect alertness and physical/mental wellbeing) participated. Over a course of four months, the women were asked to take a daily 80 mg isoflavone pill (primarily made up of genistein) or a sugar pill. During the study, all women had blood work done, were visited monthly by a researcher to discuss their menopausal symptoms/complaints, and underwent sleep assessments.

The researchers say that they found that use of daily isoflavones actually decreased the frequency of insomnia by as much as 30%, and increased sleep efficiency — the ratio of time asleep to time spent in bed — by as much as 6%. Apparently, women using isoflavones also had fewer and less intense hot flashes.

Importantly, the researchers say that there is a paucity of published sleep studies in menopausal women and even fewer that look at alternative or complementary therapies. Nevertheless they point out that by using a standard of sleep analysis — polysomnography – they were able to demonstrate significant objective improvements in insomnia among women taking isoflavones. In contrast, studies reporting improvements in sleep after hormone therapy have been based on subjective reports.

Another critical point that they make is that although this was a small study, almost 70% of women had objectively defined insomnia, demonstrating the breadth of the problem in menopause. Moreover, sleep disturbances that drove these women to seek help tended to be individualized, indicating that there is a depth of insomnia-related complaints that affect aging women in this stage of their lives that warrant a closer look.  Still, despite these differences, soy appeared to work well across the range of complaints.

Are closer to unlocking the chicken versus egg, ie aging versus factors mystery surrounding sleep? Perhaps not. And it’s unlikely that soy will work exactly the same for each person. No medicine does. However, soy appears to be a safe and potentially effective treatment for sleep disturbances during menopause.

How’s your sleep? And what steps are you taking to improve it? `

Heart disease, flashes and sweats, oh my!

Posted by Liz on Feb 11, 2011 in heart disease | 1 comment

Heart disease is a major issue in women, especially as they age. In fact, more women die of heart disease than all forms of cancer, including breast cancer. During the time right before and up to five years after menopause starts, cholesterol and low-density lipoprotein (LDL) levels soar, placing women at even greater risk.

I’ve written previously about the link between waning estrogen levels and heart disease risk and steps you can take to address specific risk factors. But what about vasmotor symptoms like hot flashes and night sweats? Unfortunately, in addition to being linked to elevated cholesterol and LDL, researchers are discovering that vasomotor symptoms like hot flashes and night sweats actually cause calcium deposits to build up in the arteries and aorta, negatively blood pressure and increase body mass index compared to women without these symptoms.

In the latest bit of news from the research front (published in February issue of Menopause), it appears that night sweats might be the larger culprit. In fact, when researchers examined data culled from 10,787 Dutch women (mean age 53) participating in another study who were free of heart disease at the start, they discovered that over a period of approximately 10 years, women reporting night sweats had a 33% increased risk for heart disease compared to women who were asymptomatic. In comparison, hot flashes did not appear to increase risk in any significant way. What’s more, risk remained even after the researchers accounted for factors that might influence risk, such as BMI, blood pressure and total cholesterol. Additionally, elevated risk was even seen among women both who had used hormone replacement and had never used hormone therapy or oral contraceptives.

Before you become anxious about these findings, it is important to note that when the researchers did a second analysis that adjusted for sleep and mood (both of which have been linked to vasomotor symptoms and heart disease), and found that while risk was still elevated, it was no longer significant. This implies that factors other than night sweats might also be contributing to heart disease risk, and that the sympathetic nervous system, which is responsible for increases in nervous system activity and blood vessel abnormalities, may also play a role.

Meanwhile, prevention recommendations continue to be fairly straightforward:

• Don’t smoke or quit if you do.
• Exercise…at least an hour daily if you can.
• Eat a health diet, rich in whole grains, fruits and vegetables, healthy fats, fish oils and low fat proteins.
• Maintain a healthy weight.
• Drink in moderation.

Ladies, we are in control of our destinies when it comes to altering how we age in that we can influence certain factors. There are no guarantees. But you can bet that we can change the odds in our favour.

Please, please care for your heart. It matters. A lot.

Dem bones! Isoflavones, S-equol and aging

Posted by Liz on Feb 7, 2011 in bone health | 1 comment

I love it when readers of this blog point me to research that I might have missed or just not stumbled across. That happened a few weeks ago after I wrote a post on soy and safety. By following the links, reader Carol Land directed me to a newly published study on S-equol and bone health.

S-equol is a metabolite of a major soy isoflavone called daidzein. It has a particular affinity for estrogen receptors and possesses some estrogen-type activity of its own. S-equol  is produced in the gastrointestinal tract however the ability to actually manufacture it depends on the presence of certain microflora. Consequently, only 30% to 60% of individuals are actually able to produce S-equol on their own (although this figure is believed to be higher among Asians and vegetarians).

The surge in interest in S-equol is related to its potential for augmenting the benefits of isoflavones; in fact, it is possible that women who are naturally producers of S-equol actually experience greater effects from soy products, and this is especially true when it comes to bone health.

I cannot stress enough the importance of bone health as we age. Declining levels of estrogen are a primary cause of bone loss and resulting osteoporosis in women; indeed, one in five American women over the age of 50 have osteoporosis and about half will experience a fracture in the hip, wrist or spine as a result. What’s more, because osteoporosis is silent in its early stages, causing no symptoms, it’s critical that bone loss is halted or at least slowed either before or during the most critical phases strike. There is no time like the present to take preventive measures, even if you are in your 30s and 40s.

Where does S-equol fit in?

For the first time, researchers have shown the daily S-equol supplements taken by women who are not naturally producers of S-equol, may improve bone metabolism and attenuate bone loss!

In this 1 year study of 356 healthy, postmenopausal Japanese women between the ages of 41 and 62, daily intake of 10 mg S-equol via supplement markedly reduced markers of bone resorption in blood and urine compared to women taking placebo pills or 2 mg or 6 mg of S-equol daily. In fact, in women taking the 10 mg dose for a year, declines in a  urinary marker of bone resorption (i.e. DPD) were roughly 21% greater compared to placebo. Measures of whole body bone mineral density also showed that S-equol supplementation protected against bone loss, although not to the extent as bone resorption. These results remained even after changes in height, weight, body mass index, lean and fat mass were accounted for. No participant experienced serious side effects from taking S-equol and hormone levels were not adversely affected.

Does this mean that you should rush out and purchase S-equol supplements?

One of the primary limitations of this study is that the process of bone recycling can take as long as 18 months and the time required to complete a cycle may actually increase with age. Thus, the duration of time that the women were studied might be too short to draw any definitive conclusions. Hence,  you may want to wait before you start taking S-equol. However, the evidence that’s building continues to put the weight on the benefits versus risks side. Only time will tell. Meanwhile – here’s to your bone health. Keep on doing all you can do to keep dem bones.

Wednesday Bubble: Holy Hot Flash Menopause Woman!

Posted by Liz on Feb 2, 2011 in breast cancer | 5 comments

Bet you never thought you’d hear holy and hot flash in the same sentence! However, it appears that menopausal hot flashes, those bothersome, sweat inducing, embarassment producing, change of clothing inducing symptoms might actually deliver something better than a whole lotta dread. And so, dear readers, after the bad breast cancer news that I delivered on Monday, I’m happy to report some good!

You mean I WANT hot flashes? Well not exactly. But there sure is a interesting paradigm hidden somewhere in the diminishing returns of estrogen, that is, severe, wake you in the middle of the night or interrupt your meeting hot flashes might actually reduce risk for invasive breast cancer.

As we know all too well, menopausal symptoms often occur as estrogen and progesterone levels fluctuate and the ovaries cease to function reproductively.  However, utilizing data culled from a study whose original intent was to evaluate the link between hormone therapy and risks of different types of breast cancer, researchers have actually uncovered some positivity! In this study, women between the ages of 50 and 74 were randomly selected based on confirmed invasive breast cancer and then matched by age to healthy women. All were interviewed about their reproductive history, menstruation/menopause history, use of hormones, BMI, medical history, family history of cancer and use of alcohol.  They were also asked specifically about their experience with menopausal symptoms, including hot flashes, night sweats, vaginal dryness, bladder issues, irregular menstruation, depression, anxiety, emotional distress and insomnia and requested to rate them based on their frequency and severity.

Interesting enough, women who reported menopausal symptoms had a 40% to 60% lower risk of the type of invasive breast cancer that starts in the milk ducts (i.e., invasive ductal carcinoma or IDC) and invasive breast cancer that starts in the glands at the end of the milk ducts (i.e. invasive lobular carcinoma or ILC). Moreover, reduced risk for these cancers as well as the mixed ductal/lobular type was especially pronounced among women who experienced hot flashes with perspiration or whose hot flashes woke them up compared to women who had hot flashes without perspiration or others symptoms with awakening during the night.

The researchers say that they believe that menopausal symptoms may be markers for hormonal changes that precipitate breast cancer. In other words, pronounced the changes in reproductive hormones may actually be related to breast cancer risk. Less clear are the direct connections between individual symptoms and risk. However, they noted that the relationship between symptoms and risk did not change when hormone use, age when menopause began or BMI were factored into the equation.

Clearly, this is only one study so no firm conclusions can be drawn, at least not yet. But with all the bad news about hormone therapy and breast cancer risk, it’s heartening to learn that the hormones that are wreaking havoc on our lives may actually be protecting us from harm.

Holy hot flash indeed!